Transjugular Intrahepatic Porto-Caval Shunt (TIPS) in treatment of portal hypertension in liver transplant recipiens
Tadeusz Wróblewski, Olgierd Rowiński, Jerzy Żurakowski, Bogna Ziarkiewicz-Wróblewska, Krzysztof Zieniewicz, Paweł Nyckowski, Marek Krawczyk
Ann Transplant 2008; 13(2): 42-45
Available online: 2008-06-17
Background: TIPS, as non-operative treatment of portal hypertension allows for safe awaiting liver transplantation for patients otherwise at high risk of hemorrhage from oesophageal varices veins. When endoscopic treatment fails, TIPS is a plausible and less hazardous alternative for surgical porto-systemic shunts. It is of particular importance in patients with liver failure and unacceptable operative risk (group C in Child-Pugh classification).
Material/Methods: TIPS was done in 96 patients aged 16–68 years (average 52 years). According to Child-Pugh classification, which documents a stage of liver failure, 60 patients (62%) were in group B, and 36 (38%) in group C. Patients from group C are in most severe condition and at highest operative risk. Postalcoholic and postinflammatory liver cirrhosis is a main cause of portal hypertension.
Results: TIPS was done in 26 patients expecting liver transplantation. Twenty patients had subsequently undergone liver transplantation while remaining 6 are still on the waiting list. In 15 patients stenosis of the shunt was observed within a year. Stenosis was then treated with intervention radiology and implantation of supplemental stents.
Conclusions: TIPS as a non-operative option for treatment of portal hypertension gives a patient an opportunity to await liver transplantation with maximum possible safety. Considering these facts, TIPS is called a bridge to liver transplantation.
Keywords: portal hypertension, TIPS, Liver Transplantation